By Christine Monahan
Over the last several months, faculty and staff at CHIR and their sister Center, Georgetown’s Center for Children and Families (CCF), have been providing support and technical assistance to navigators and others assisting consumers with enrollment in the new health insurance Marketplaces.* While the enrollment process can be tricky at multiple steps, navigators report that it can be particularly difficult when it comes time for consumers to make their plan selection. Consumers can face dozens – and even hundreds – of different plan options. And because health insurance is a multi-dimensional product, with different covered benefits, different cost-sharing structures, and different provider networks, consumers frequently have a hard time figuring out which plan is right for them.
That’s why non-profit consumer rating provider Consumers’ CHECKBOOK launched a new website last month to help Illinois residents compare their health plan options: healthplanratings.org. Consumers’ CHECKBOOK has previously offered similar support to more than 8 million federal employees.
Recognizing that health insurance is more than just another monthly bill, healthplanratings.org offers a lot of metrics on which to compare plans that go beyond premiums and deductibles. Taking into consideration a number of self-reported variables, including age, health status, tobacco use, and expected medical procedures, the website will provide an estimate of the total average costs you can expect to pay over the year, reflecting both premiums and cost-sharing expenses. It also tells you what sort of financial risk you may be exposed to in a “bad” year. The comparison tool displays a customizable five star quality rating that allows you to assess plans on metrics that matter to you – like the ability to get needed care quickly, care coordination services, and whether members get appropriate care for different conditions. You can also search plans by doctors – although the website wisely cautions that you should contact the doctor directly before picking a plan to confirm that they are in fact in network.
Unlike Healthcare.gov, healthplanratings.org doesn’t directly enable you to purchase and enroll in coverage. And, while it includes a basic calculator to give you a rough estimate of whether or not you might be eligible for a subsidy, consumers are advised to go to either healthcare.gov or contact the state Medicaid agency to get an official determination. The About Us section of the website reports that Consumers’ CHECKBOOK is working with states as they continue to develop their online marketplaces, in addition to Illinois. Ideally, both state and federally run marketplaces will directly integrate more of these innovative plan comparison tools so consumers can benefit from a real one-stop-shopping experience and don’t need to click back and forth between different websites.
It’s also important to remember that the effectiveness of any of these tools is only as good as their inputs. As we discussed in our December 2013 report for the Commonwealth Fund, a number of state-based marketplaces have taken steps to further improve consumer choice through plan management tools. For example, to prevent insurers from overwhelming consumers with too many similar-looking plans that are hard to distinguish even with the best comparison tools, marketplaces can limit the number of plans insurers can offer or require that any given insurer’s plans be “meaningfully different” from their other plans on the marketplace. Or, to help consumers make “apples-to-apples” comparisons, marketplaces can standardize the benefits and cost-sharing of plans across different levels of coverage. This way, consumers can quickly identify which cost-sharing structure best meets their needs and focus on comparing different plans on the basis of provider networks, premiums, or quality metrics. To learn more about which states have taken up these options, check out our report here.
Editor’s Note: CHIR and CCF’s Navigator support project is made possible thanks to generous support from the Robert Wood Johnson Foundation.
Editor’s Note: Christine Monahan is a former senior health policy analyst for CHIR. She is currently pursuing a law degree at Yale Law School.
